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Correlation between osteoporosis and tooth loss

PI: Anne-Marie Bollen, D.D.S., M.S., Ph.D., Associate Professor Orthodontics, School of Dentistry, University of Washington

The purpose of this study was to evaluate the hypothesis that osteoporotic fractures are a risk factor for tooth loss and to determine if there is a significant difference in cortical anatomy of the lower border of the mandible between elderly subjects with and those without osteoporotic fractures.

We used a case control study design. Patient interviews (n=506) obtained information on fracture status. Reported history of fractures was used to classify the patient as a case or control: a fracture occurring after minimal impact (falling from height smaller than standing height) was classified as an osteoporotic fracture, and a fracture occurring after large impact (motorcycle accident, fall out of a tree) was classified as a traumatic fracture. Panoramic radiographs available in the dental charts were analyzed for mandibular cortical thickness and anatomy, and fractal dimension.

We found no difference in the number of teeth between the fracture groups, although there was a significant difference in mandibular cortical bone thickness and anatomy between the fracture groups. Subjects with a history of osteoporotic fractures had a thinner cortex with more erosions than subjects without fractures or a history of traumatic fractures. Elderly subjects with a thin and eroded cortex are at risk for developing osteoporotic fractures. Dentists may note this anatomical feature and refer patients to their physician for further evaluation and possible treatment.

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